| NPI | 1760406078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA at001616) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: TX 794219) |
| 146N00000X Emergency Medical Technician, Basic (Licence: E3881703) | |
| 225100000X Physical Therapist (Licence: GA PT013778) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT006939) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT10020) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2025-02-11 |