NPI | 1043628746 |
---|---|
Former Name | KASEY RICHARDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A00635) |
Enumeration Date | 2014-07-25 |
Last Update Date | 2023-08-29 |