| NPI | 1043778228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 3737) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MN 989387) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 3182-39) | |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2025-09-22 |