| NPI | 1386279867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: PA RT007825) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2021-11-09 |