| NPI | 1780300772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY AT2304) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NM AT-2025-0004) |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2025-10-24 |