| NPI | 1295118164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DE J3-0000438) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RTO000108) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A00711) | |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-07-09 |