| NPI | 1467855122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NY 001612) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: VT 104.0106368) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2024-07-29 |