| NPI | 1043353659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00129300) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: PA RT005501) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2013-09-03 |