NPI | 1235761719 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 4291) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA 006752) |
Enumeration Date | 2020-02-12 |
Last Update Date | 2020-02-12 |