| NPI | 1528515269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 00027) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: IA 00027) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2021-11-11 |