| NPI | 1073060869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MA 2181) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: RI AT00303) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2021-12-09 |