NPI | 1235516295 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.004600) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126002295) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002187A) | |
Enumeration Date | 2015-04-29 |
Last Update Date | 2022-10-11 |