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 |