NPI | 1083077176 |
---|---|
Former Name | KATHLEEN MECH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 24-00918) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2012020310) |
Enumeration Date | 2016-04-05 |
Last Update Date | 2016-04-05 |