| NPI | 1902890460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 674-039) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 00093) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 1824) | |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2007-07-08 |