| NPI | 1073292876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KS 24-01550) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: KS 11-06799) |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-07-18 |