| NPI | 1275614042 |
|---|---|
| Former Name | BECKY ANN BUBECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT003492) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |