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 |