| NPI | 1891243531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NC 4233) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: TN 0000002645) | |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2022-08-03 |