NPI | 1013592070 |
---|---|
Former Name | KARLY FRANCES LITTLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.003781) |
Enumeration Date | 2021-03-11 |
Last Update Date | 2021-03-11 |