| NPI | 1053710939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL3921) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: FL AL3921) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2014-08-31 |