| NPI | 1285970681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126001642) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A00302) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 7445114-4810) | |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2012-12-13 |