| NPI | 1376064527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: CO AT.0001905) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: AZ 1505) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2018-08-20 |