| NPI | 1346648441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601001360) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH 004572) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: HI 75) | |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2016-07-20 |