| NPI | 1689340135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC AT03117) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003386) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT8172) | |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2021-08-16 |