| NPI | 1942751680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KS 24-01791) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: LA 301376) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2024-09-19 |