| NPI | 1134651458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: CO AT.0001808) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: TX AT5911) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2018-12-18 |