| NPI | 1487902912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN61056644) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MT MED-EMTB-LIC-13491) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA A1 60494144) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OR AT-AT-10149900) | |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2021-02-26 |