| NPI | 1306313317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: ND 856-19) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: ND 145677) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: ND 0990709) | |
| Enumeration Date | 2018-10-28 |
| Last Update Date | 2020-10-26 |