NPI | 1063182483 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: SC 1059) |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: SC 602665) |
Enumeration Date | 2021-09-16 |
Last Update Date | 2024-06-03 |