| NPI | 1073920765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: DE J3-0000298) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: PA RT004448) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2019-10-26 |