| NPI | 1831507854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DC AT23000041) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: BOC110702025) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL3268) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126001390) | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2025-05-08 |