| NPI | 1336566033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: PA RT004890) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MD A0000496) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2020-04-20 |