| NPI | 1912772625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 2000015288) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: CA CFo05773) |
| Enumeration Date | 2023-11-22 |
| Last Update Date | 2023-11-22 |