| NPI | 1518935212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 246-039) |
| Additional Taxonomies | 225500000X Specialist/Technologist |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2015-12-11 |