| NPI | 1154818011 |
|---|---|
| Former Name | MARY PATRICIA IRVIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36001360A) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-17 |