NPI | 1508324070 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0000962) |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MD 1852246) |
Enumeration Date | 2019-03-04 |
Last Update Date | 2019-03-04 |