NPI | 1417486341 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: FL AL1579) |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: FL 538392) |
Enumeration Date | 2017-06-05 |
Last Update Date | 2017-06-05 |