| NPI | 1215972872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1240) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2009-01-22 |