| NPI | 1245721968 |
|---|---|
| Former Name | DOMINIQUE LILLIAN MCCRAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-3877) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NC P092137) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 2000031606) | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2023-01-05 |