| NPI | 1164284857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000057514) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: IN 40313283) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2025-05-23 |