NPI | 1487038469 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT5948) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NH 2539) |
Enumeration Date | 2015-07-19 |
Last Update Date | 2015-07-19 |