| NPI | 1033681861 |
|---|---|
| Former Name | KATHERINE FULK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL5724) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-3533) |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2019-08-02 |