| NPI | 1861519878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 2418) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL 2144) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 1173) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2016-05-02 |