| NPI | 1912380098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: FL AL4228) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: GA AT003323) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2018-10-09 |