NPI | 1114076544 |
---|---|
Former Name | EVA ANNE BAETEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 1678-39) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 96002146) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2024-07-23 |