| NPI | 1942419353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other (Licence: NE 483) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SD 0250) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2014-06-13 |