| NPI | 1275725285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other Surgical Technologist |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: GA AT001429) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2011-07-12 |