NPI | 1245242460 |
---|---|
Former Name | JAMIE LYNN GRACIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT001322) |
Enumeration Date | 2006-08-13 |
Last Update Date | 2007-07-08 |