| NPI | 1326524471 |
|---|---|
| Former Name | MCKENZIE SARA MIESSAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 1352) |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2024-05-28 |