NPI | 1851930002 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VT 104.0133997) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NH 0700) |
Enumeration Date | 2020-01-04 |
Last Update Date | 2024-09-29 |