| NPI | 1689052714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 1486) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 003512) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT005918) | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2019-12-23 |