NPI | 1134595028 |
---|---|
Former Name | ELIZABETH DEMYAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH 2000010917) |
Enumeration Date | 2015-08-14 |
Last Update Date | 2015-08-14 |