| NPI | 1346274321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2011013606) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 36001176A) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2015-10-30 |