NPI | 1720526205 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A01165) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 2450) |
Enumeration Date | 2017-02-06 |
Last Update Date | 2019-05-23 |