| NPI | 1093240996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH UA866609) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH UA866609) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2019-05-22 |