| NPI | 1235242637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: TN AT0000001253) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: WI 565-039) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2009-08-17 |