| NPI | 1346800265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 54464) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 54464) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-13 |