| NPI | 1508305327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 20000017381) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA E3297785) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |