| NPI | 1225545502 |
|---|---|
| Former Name | KELSEY JO GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 742) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OK 742) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-01-08 |