NPI | 1164673547 |
---|---|
Former Name | KRISTINA MARIE KOBBEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.001378) |
Enumeration Date | 2008-10-03 |
Last Update Date | 2010-02-05 |