| NPI | 1285198010 |
|---|---|
| Former Name | BRANDI JEAN RIESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IL 096005352) |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2024-11-16 |