| NPI | 1881226215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: DC AT23000065) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 27754) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MD A0001434) | |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2024-03-06 |