| NPI | 1215177142 |
|---|---|
| Former Name | KIMBERLY ANNE RUPP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126001280) |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2014-10-16 |