| NPI | 1669441226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RTO000409) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601001420) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096-001914) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2020-08-13 |