| NPI | 1073103024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NH 1402) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NY 003750) |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2021-01-24 |
| Last Update Date | 2021-01-24 |