| NPI | 1164199683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AR 959) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: AR 959) |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2021-09-25 |