| NPI | 1881606333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: MO 2000154563) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MO 116345) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2007-07-08 |