| NPI | 1528523933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MA 3474) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NC LAT-3820) |
| Enumeration Date | 2019-02-10 |
| Last Update Date | 2023-01-20 |