| NPI | 1811475429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NE 848) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NE 22372) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-08-06 |