| NPI | 1780376806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096003087) |
| Additional Taxonomies | 163WX0800X Registered Nurse, Orthopedic (Licence: IL 041374169) |
| Enumeration Date | 2023-05-25 |
| Last Update Date | 2023-05-25 |