NPI | 1093782948 |
---|---|
Former Name | CHRISTINE ANNE GOYETTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096-001110) |
Enumeration Date | 2006-02-28 |
Last Update Date | 2007-07-08 |