NPI | 1174745558 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 7728452-4810) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT3224) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2014-08-04 |