NPI | 1043795099 |
---|---|
Former Name | GABRIELLA ANDREWS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601002203) |
Enumeration Date | 2018-09-26 |
Last Update Date | 2021-12-09 |