| NPI | 1295303089 |
|---|---|
| Former Name | KAITLYN NICOLE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT004349) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2023-06-09 |