| NPI | 1700261690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 010333055) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: LA 010333055) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-07-21 |