| NPI | 1992365498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: ND 808-18) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: ND E3446979) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-17 |