| NPI | 1215965926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-2924) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: NJ 25MT00056400) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00056400) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2017-03-01 |