NPI | 1275664120 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VT 1040000123) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NH 0303) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2007-07-08 |