NPI | 1528589355 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 002955-1) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00227100) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT006464) | |
Enumeration Date | 2017-07-01 |
Last Update Date | 2018-03-17 |