| NPI | 1689074098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0000966) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: VA 0126001088) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126001088) | |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2021-08-03 |