| NPI | 1801274089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT005342) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: OH 0173393) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY AT1560) | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2022-08-30 |