| NPI | 1275068892 |
|---|---|
| Former Name | ELISHIA ANDRADA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: WA A160668335) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2017-04-21 |