| NPI | 1053839902 |
|---|---|
| Former Name | HANNAH MAE ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0002344) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2024-12-05 |