NPI | 1235414236 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 2103) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA RT004991) |
Enumeration Date | 2011-10-21 |
Last Update Date | 2014-01-22 |