| 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 |