| NPI | 1871882944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 2113-39) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.003460) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT.003398) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2020-09-25 |