| NPI | 1356089692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601002606) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MI 2009702) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2022-05-31 |