| NPI | 1184390643 |
|---|---|
| Former Name | JENNIFER STANSHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 2000000185) |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2021-08-16 |