| NPI | 1922071950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096000371) |
| Additional Taxonomies | 171W00000X Contractor (Licence: IL 096-000371) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2012-01-24 |