| NPI | 1639101496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: NC Certification) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 0580) |
| 225700000X Massage Therapist (Licence: NC 724) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-07-08 |