NPI | 1912414087 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX 1862) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX 040502022) |
Enumeration Date | 2018-01-10 |
Last Update Date | 2018-01-10 |