NPI | 1194970541 |
---|---|
Former Name | ERYNNE NICOLE BROTHERTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 070202254) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 07003020) |
Enumeration Date | 2008-11-26 |
Last Update Date | 2024-08-29 |