| NPI | 1497189260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AR 759) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 2149) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 1731) | |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2017-05-11 |