| NPI | 1104418946 |
|---|---|
| Former Name | CALLIE LUCINDA TOSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2024000700) |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2024-06-24 |