NPI | 1164812640 |
---|---|
Former Name | ASHLEY MARIE BRAWFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126001434) |
Enumeration Date | 2015-02-04 |
Last Update Date | 2015-03-03 |