| NPI | 1053821108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT005988) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A00694) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DE J3-0000657) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00202100) | |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |