| NPI | 1013426287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: TN AT0000001438) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MS AT0800) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2018-03-17 |