NPI | 1124477302 |
---|---|
Former Name | CARINA MICHELLE STERN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT7268) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126002452) |
Enumeration Date | 2016-06-08 |
Last Update Date | 2017-12-27 |