| NPI | 1790576023 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer | 
| Enumeration Date | 2025-05-15 | 
| Last Update Date | 2025-05-15 |