| NPI | 1568987576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NV 0506464) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: VA 0126002742) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2022-07-21 |