NPI | 1588126569 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 2000040570) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
Enumeration Date | 2019-04-01 |
Last Update Date | 2020-11-10 |