| NPI | 1073204558 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer | 
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic | 
| Enumeration Date | 2023-05-16 | 
| Last Update Date | 2025-06-09 |