NPI | 1336715937 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-3973) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT006882) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ME AT797) | |
Enumeration Date | 2021-06-03 |
Last Update Date | 2021-06-03 |