NPI | 1346206026 |
---|---|
Other Name | BJ LOUGH |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT2804) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT1289) |
Enumeration Date | 2006-04-21 |
Last Update Date | 2015-01-21 |