| NPI | 1225592538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT005293) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY AT1450) | |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2025-08-31 |