| NPI | 1265836944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL00540700) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2019-11-29 |