| NPI | 1053711051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002241A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY AT870) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0000502) | |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |