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 |