| NPI | 1215343371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC RT006446) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT006446) | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2022-01-10 |