| NPI | 1245431568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NC LAT-2585) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH AT. 002774) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2016-01-10 |