| NPI | 1598389488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: LA 320563) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003108) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MS AT-982) | |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2020-06-05 |