| NPI | 1063887115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36003061A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IL 096.003993) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2018-10-22 |