NPI | 1144640012 |
---|---|
Former Name | KERRI VENTRESCA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ME AT409) |
Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: ME 26731) |
Enumeration Date | 2014-04-18 |
Last Update Date | 2014-08-26 |