| NPI | 1588632293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 235500000X Specialist/Technologist (Licence: NE 16) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-01-03 |