| NPI | 1598219461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 2625) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT6817) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN BOC310111) | |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2020-03-02 |