NPI | 1346823382 |
---|---|
Former Name | KENNEDY PAIGE HARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000054230) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT9509) |
Enumeration Date | 2021-04-28 |
Last Update Date | 2024-08-26 |