| NPI | 1982361846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MI 86090013) |
| Enumeration Date | 2021-11-25 |
| Last Update Date | 2024-04-22 |