| NPI | 1225065923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT003499) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: OH 189403) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2023-07-26 |