| NPI | 1497478374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC P017054) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P017054) |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2022-09-26 |