| NPI | 1194368712 |
|---|---|
| Former Name | COURTNEY FRIESE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MD A0000960) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126003291) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT006480) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0000960) | |
| Enumeration Date | 2019-10-27 |
| Last Update Date | 2020-12-20 |