| NPI | 1861744781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2021-07-29 |