| 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 |