| NPI | 1174149389 |
|---|---|
| Former Name | THANIA D SEGURA BARRON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: ID AT-751) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |