| NPI | 1346371739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 3159-39) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096002366) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2023-09-29 |