NPI | 1710535448 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003993) |
Additional Taxonomies | 225700000X Massage Therapist |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-08-27 |
Last Update Date | 2023-01-24 |