| NPI | 1881894962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: DE J3-0000457) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: AZ 0683) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NY 001701-1) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2016-01-14 |