| NPI | 1528505047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY AT1497) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 246Z00000X Specialist/Technologist, Other | |
| Enumeration Date | 2017-01-22 |
| Last Update Date | 2020-10-22 |