| NPI | 1982030268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 24-00819) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 1402586) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2023-05-10 |