| NPI | 1871987958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224L00000X Pedorthist |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MI 3640200) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2015-03-26 |