| NPI | 1265874564 | 
|---|---|
| Former Name | KATHERINE ROSE LAGUENS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL2766) | 
| Enumeration Date | 2013-07-27 | 
| Last Update Date | 2013-07-27 |