| NPI | 1154881084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DE J3-0000686) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00243300) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT006923) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000028269) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-03-25 |