NPI | 1124626825 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT2625) |
Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: TX AT2625) |
Enumeration Date | 2020-10-14 |
Last Update Date | 2022-04-18 |