NPI | 1326469180 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 1996-39) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT004531) |
2255A2300X Specialist/Technologist, Athletic Trainer | |
Enumeration Date | 2013-12-21 |
Last Update Date | 2020-04-10 |