NPI | 1164924338 |
---|---|
Former Name | ASHLEY LATTANZIO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002746A) |
Enumeration Date | 2018-03-05 |
Last Update Date | 2018-03-05 |