NPI | 1134157423 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 246Z00000X Specialist/Technologist, Other (Licence: MA 8265) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NH 0218) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 1472) | |
246Z00000X Specialist/Technologist, Other (Licence: NH 947) | |
Enumeration Date | 2006-06-28 |
Last Update Date | 2016-04-26 |