| NPI | 1265795132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH AT000995) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KY AT353) |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2013-03-06 |