| NPI | 1871008490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: SC AT03180) |
| Additional Taxonomies | 2083S0010X Preventive Medicine Sports Medicine (Licence: PA RTO000366) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2022-05-25 |