| 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 |