| NPI | 1134592637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000009239) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AL 1721) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT002174) | |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2020-12-16 |