NPI | 1023470986 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL5567) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-3045) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 24-01007) | |
Enumeration Date | 2016-03-22 |
Last Update Date | 2022-08-16 |