| NPI | 1033723226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: VT 104729) |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2021-06-23 |