| NPI | 1043751266 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RTO000069) | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT002402) | 
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00152100) | |
| Enumeration Date | 2017-03-20 | 
| Last Update Date | 2017-03-20 |