| NPI | 1124203492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 561) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: 13-618) |
| 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant (Licence: 1052) | |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2018-04-23 |