| NPI | 1396386074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MA 3562) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2022-10-10 |