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 |