| NPI | 1710457932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SD 0361) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: SD 1558) |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-11-30 |