| NPI | 1427770767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000053516) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ Student) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2023-05-30 |