| NPI | 1104462498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT8371) |
| Additional Taxonomies | 227800000X Respiratory Therapist, Certified |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT0002958) | |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2026-08-24 |