| NPI | 1841762515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36002762A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: AZ 1470) |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2020-12-12 |