| NPI | 1013402114 |
|---|---|
| Former Name | JORDAN RATELLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601002534) |
| Enumeration Date | 2018-06-30 |
| Last Update Date | 2026-04-03 |