| NPI | 1700276821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: VA 0126002171) |
| Additional Taxonomies | 207PS0010X Emergency Medicine Sports Medicine (Licence: VA 0126002171) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2018-07-26 |