| NPI | 1881029817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: PA 2000010360) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: PA 152853) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-09-10 |