| NPI | 1598250037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL5965) |
| Additional Taxonomies | 183700000X Pharmacy Technician |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2022-05-10 |