| NPI | 1063757219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601001564) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 2402) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096004795) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WY 068) | |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2023-10-16 |