| NPI | 1215493838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 10877423-4810) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: UT 10877423-4810) |
| 2083S0010X Preventive Medicine, Sports Medicine (Licence: UT 10877423-4810) | |
| 405300000X Prevention Professional (Licence: UT TBA) | |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-02-19 |