| NPI | 1518203488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT004306) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: PA 164776) |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2012-12-21 |