| NPI | 1992873517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT002431) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 0663) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL 566) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2018-08-29 |