| NPI | 1841665478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003884) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL 4546) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002465A) | |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2021-08-25 |