NPI | 1629355219 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36001878A) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IL 096.003173) |
Enumeration Date | 2011-11-09 |
Last Update Date | 2011-11-09 |