| NPI | 1750342648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: WA B1597244) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2007-07-08 |