| NPI | 1316489578 |
|---|---|
| Former Name | STEPHANIE BROWN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096003185) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-11-04 |