| NPI | 1558712281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2017011126) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096003282) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ 001042) | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2023-08-07 |