| NPI | 1609363100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT6939) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000024157) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.004271) | |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-04-19 |