NPI | 1710450473 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA 1588) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 1130) |
Enumeration Date | 2019-01-05 |
Last Update Date | 2020-08-31 |