NPI | 1679621106 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: RI AT00197) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT002498A) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2007-07-08 |