| NPI | 1952425514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: FL AL1031) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: TX AT3804) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2022-12-12 |