| NPI | 1316420276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000038868) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC ATR.1965ATH) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2025-07-15 |