| NPI | 1306346317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator (Licence: PA 3459492) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA 3375058) |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2018-05-10 |