| NPI | 1619633807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NM AT22023) |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2024-04-01 |