| 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 |