| NPI | 1225356785 |
|---|---|
| Other Name | VINCE FEDOROWICH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2016033787) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126001216) |
| Enumeration Date | 2010-05-08 |
| Last Update Date | 2019-06-19 |