NPI | 1356934244 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC SC029588) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 909) |
Enumeration Date | 2021-02-11 |
Last Update Date | 2021-02-11 |