NPI | 1063601524 |
---|---|
Former Name | BRIANNA HEATHER FRYE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ME ATC264) |
Enumeration Date | 2007-10-22 |
Last Update Date | 2007-10-22 |