NPI | 1013088558 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 1155) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MS AT0360) |
Enumeration Date | 2006-11-13 |
Last Update Date | 2022-07-21 |