| NPI | 1023568797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC SC529906) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2020-08-08 |