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 |