| NPI | 1497259485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT007635) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00290600) | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2021-11-03 |