| NPI | 1518395326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VT 080302236) |
| Additional Taxonomies | 133N00000X Nutritionist |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2020-11-02 |