| NPI | 1063927663 |
|---|---|
| Other Name | MATT S DELISI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA A160885436) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2021-03-19 |