| NPI | 1023387545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH AT000985) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: PA RT001029B) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2023-06-28 |