| NPI | 1619568037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: CO Q190029) |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |