| NPI | 1669897518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT002622) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH 003636) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA 005229) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601000882) | |
| 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant (Licence: 13-1108) | |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2016-10-12 |