| NPI | 1528778578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: AZ 11025893-4810) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: UT 11025893-4810) |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2022-11-30 |