| NPI | 1851742548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT004063) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126002515) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0001102) | |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2023-08-30 |