| NPI | 1043696099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: LA ATH.200357) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001180) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL2697) | |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |