| NPI | 1134675325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003737) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 2255A2300X) | |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2021-02-17 |