| NPI | 1861910630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI M255603585273) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI M225603585273) |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2022-07-21 |