NPI | 1144770397 |
---|---|
Former Name | REBECCA SOPHIA HERR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL2855) |
Enumeration Date | 2016-10-12 |
Last Update Date | 2016-10-12 |