| NPI | 1134760564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202216060) |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2019-10-07 |