NPI | 1053840413 |
---|---|
Former Name | JACQUELINE ANNE LLOYD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: GA AT004124) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO 2000028113) |
Enumeration Date | 2017-06-08 |
Last Update Date | 2023-08-13 |