| NPI | 1215313689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT7850) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: OK 761) |
| 174H00000X Health Educator | |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2022-06-15 |