| NPI | 1992552335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: SD 0789) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NE 1159) |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-05 |