| NPI | 1356852974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY AT1758) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001740) |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2020-08-10 |