| NPI | 1326606856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer |
| Additional Taxonomies | 133NN1002X Nutritionist Nutrition, Education |
| 261QH0100X Clinic/Center Health Service | |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |