| NPI | 1245380971 |
|---|---|
| Former Name | AMBER MARISA MOURING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AR AT 280) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-08 |