| NPI | 1811303522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH 004361) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: AL 629) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-09-29 |