| NPI | 1265206783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT004653) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: GA E3554572) |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2025-07-08 |