| NPI | 1558604181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 2500) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2010028876) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO 1088) | |
| 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: CO SA.0001691) | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2013-11-01 |