| NPI | 1659829638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 174H00000X Health Educator (Licence: NC LAT-3011) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2016-10-07 |