| NPI | 1104610468 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic | 
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2025-04-09 | 
| Last Update Date | 2025-04-09 |