| NPI | 1164293353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY AT2147) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 004221-01) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36003847A) | |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2024-01-16 |