| NPI | 1497908776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36001697A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IL 096-002620) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2012-01-13 |