| NPI | 1114505286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AL 2461) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ ATR-009176) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OR AT-AT-10201714) | |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2021-03-31 |