| NPI | 1457988115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: 2000037008) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NJ 25MT00269500) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NY 003935) | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-03-24 |