NPI | 1780164996 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 090681) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2014031704) |
Enumeration Date | 2018-08-16 |
Last Update Date | 2018-08-16 |