NPI | 1205203551 |
---|---|
Former Name | NICOLE MARIE GLASGOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KS 24-00832) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
Enumeration Date | 2015-08-21 |
Last Update Date | 2024-09-06 |