NPI | 1306406004 |
---|---|
Former Name | CAITLYN HAYES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096004040) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000020646) |
246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant | |
Enumeration Date | 2019-06-17 |
Last Update Date | 2023-08-18 |