| NPI | 1912762931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: FL 1210708675) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL 1190279787) |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-19 |