| NPI | 1174163802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AL 2801) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA A161179767) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 124022534810) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MT ATR-LAT-LIC-2487) | |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2024-11-20 |