| NPI | 1891322103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT1815) |
| Additional Taxonomies | 174H00000X Health Educator |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-03-25 |