NPI | 1841790136 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2017024881) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NV 0506451) |
Enumeration Date | 2018-02-14 |
Last Update Date | 2018-02-14 |