| NPI | 1932300027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NE 1450) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NE 328) |
| 146N00000X Emergency Medical Technician, Basic (Licence: NE 17863) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2008-01-22 |