| NPI | 1457329237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 119702510) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 119702510) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2022-10-26 |