| NPI | 1922372192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: CA F4954817) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: WA RATCLCL128LZ) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2016-06-22 |