| NPI | 1215550298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AT03247) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NH 34764) |
| 146N00000X Emergency Medical Technician, Basic (Licence: FL 563610) | |
| Enumeration Date | 2020-05-25 |
| Last Update Date | 2022-07-27 |