| NPI | 1952164006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 1343776) |
| Additional Taxonomies | 133N00000X Nutritionist |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-22 |