| NPI | 1417662883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: PA E3708920) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2024-07-31 |