| NPI | 1669748877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |