| NPI | 1063800662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: HI AT 135) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI RN - 78472) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT004344) | |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-01-05 |