| NPI | 1528774437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: UT 14025062-4810) |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2024-06-27 |