| NPI | 1891926416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA A161036065) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 001566-01) | |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2023-07-06 |