| NPI | 1932254828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MO 2019016501) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: KY 51439) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KY AT697) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-25 |