NPI | 1285102681 |
---|---|
Former Name | JULIA ELIZABETH GLENN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT7776) |
Enumeration Date | 2018-11-05 |
Last Update Date | 2018-11-29 |