| NPI | 1326503830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MO 2019031375) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KS 24-01450) |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2022-06-27 |