| NPI | 1235489378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DE J3-0000399) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0000317) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT005011) | |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2012-09-17 |