| NPI | 1154506152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 000438) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NH 0334) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 1625) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2009003225) | |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2020-03-23 |