| NPI | 1265955132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 000860) |
| Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine (Licence: CT 000860) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2022-07-21 |