| NPI | 1336795202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 40114825) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: TX 40114825) |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2019-08-15 |