| NPI | 1114519329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KS 24-01628) |
| Additional Taxonomies | 207PS0010X Emergency Medicine Sports Medicine (Licence: AL 2437) |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2023-10-03 |