NPI | 1457892176 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 001223) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00204900) |
Enumeration Date | 2017-03-14 |
Last Update Date | 2019-05-11 |