| NPI | 1255900429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0001712) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL7135) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126003811) | |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2024-12-05 |