NPI | 1528345634 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 7454602-4810) |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
Enumeration Date | 2011-11-03 |
Last Update Date | 2016-09-12 |