| NPI | 1104287218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 4963) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT006265) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00213800) | |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2024-05-17 |