NPI | 1760212831 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY TCA040) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 3894) |
Enumeration Date | 2024-08-05 |
Last Update Date | 2024-08-05 |