| NPI | 1801280516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.004288) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: IL 049.278041) |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2024-04-24 |