| NPI | 1053746412 |
|---|---|
| Former Name | BRIANNA LEIGH BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: WV AT001498) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: PA RT004617) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2017-01-17 |