NPI | 1265655765 |
---|---|
Former Name | MARGARET PATRICIA JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 468-039) |
Enumeration Date | 2007-04-11 |
Last Update Date | 2018-07-25 |