NPI | 1154302362 |
---|---|
Former Name | AMY ELIZABETH DOVERSPIKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 725039) |
Enumeration Date | 2005-11-07 |
Last Update Date | 2007-07-08 |