| NPI | 1003359167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2019-12-10 |