| NPI | 1184240889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NY 001234) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: FL AL3019) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |