| NPI | 1710583448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-4022) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NC LAT-4022) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: NC LAT-4022) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NC LAT-4022) | |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2020-12-08 |