| NPI | 1629476619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator (Licence: MD 23431) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MD 1504580) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2017-02-14 |