NPI | 1528608759 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT9945) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 2000040799) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT004253) | |
Enumeration Date | 2020-01-15 |
Last Update Date | 2024-12-17 |