NPI | 1114576964 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MA 3630) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MA S48958720) |
Enumeration Date | 2019-09-04 |
Last Update Date | 2021-09-03 |