| NPI | 1285682120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: PA 093547) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2007-07-08 |