| NPI | 1063932697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 2000026361) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA E092817) |
| Enumeration Date | 2017-06-24 |
| Last Update Date | 2022-08-30 |