| NPI | 1639618796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001643) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA A160310535) |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-02-21 |