NPI | 1003942608 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL5375) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AL 882) |
Enumeration Date | 2007-02-26 |
Last Update Date | 2019-09-17 |