| NPI | 1669431052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: MA 811927) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA AH-163) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2007-08-01 |