NPI | 1548738610 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MS AT0417) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 1100) |
Enumeration Date | 2018-11-07 |
Last Update Date | 2018-11-07 |