| NPI | 1972175511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 0000000000) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 00000000) | |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2021-07-13 |