| NPI | 1780126680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001978) |
| Additional Taxonomies | 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant (Licence: CO 20-0208) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2021-09-01 |