| NPI | 1699140400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00199700) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NJ 587500) |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2015-12-04 |