| NPI | 1649846437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601002195) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2023-10-17 |