| NPI | 1184282147 |
|---|---|
| Former Name | LAURA JEANNE POORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00219600) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-06-04 |