| NPI | 1548811300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DE J3-0000696) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT006614) |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |