| NPI | 1962700708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VT 104.0068948) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: VT 100360) |
| 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant | |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2022-07-12 |