| NPI | 1073644589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator (Licence: NC 322419423) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 0554) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2019-07-29 |