| NPI | 1073392072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: IN 4701-9518) |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2024-06-02 |