| NPI | 1033365879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 24-00890) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NE 450) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT3308) | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2020-02-17 |