NPI | 1225570641 |
---|---|
Former Name | TAMARIA HOLLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601001384) |
Enumeration Date | 2016-11-16 |
Last Update Date | 2020-06-15 |