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 |