| NPI | 1013472042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL4122) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: FL EMT543674) |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-02-04 |