| NPI | 1144922469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 3759) |
| Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine (Licence: MN 315556) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-10-12 |