| NPI | 1023714995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA 394581) |
| Additional Taxonomies | 225CX0006X (Licence: GA 394581) |
| 373H00000X Day Training/Habilitation Specialist (Licence: GA 394581) | |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2023-02-02 |