NPI | 1740684463 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2013030176) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 001165) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096004831) | |
Enumeration Date | 2014-10-09 |
Last Update Date | 2023-03-13 |