| NPI | 1902354061 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL5459) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2016-09-19 | 
| Last Update Date | 2024-04-15 |