| NPI | 1992259808 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT5808)  | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000020951)  | 
| Enumeration Date | 2016-08-09 | 
| Last Update Date | 2016-08-09 |