| NPI | 1760120471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: FL 579065) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL6604) | |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2022-06-17 |