NPI | 1033683222 |
---|---|
Former Name | JESSICA LEIGH CARTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003682) |
Enumeration Date | 2019-01-22 |
Last Update Date | 2022-11-30 |