| 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 |