| NPI | 1265086250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AL 2902) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: FL Al6607) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL al6607) | |
| Enumeration Date | 2019-07-28 |
| Last Update Date | 2024-07-17 |