| NPI | 1114333499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: FL AL4840) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL T520-017-93-802-0) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2019-11-25 |