NPI | 1205500113 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA A161314452) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 115167) |
Enumeration Date | 2021-08-04 |
Last Update Date | 2022-08-10 |