NPI | 1366436685 |
---|---|
Former Name | ELIZABETH ANN ST. GEORGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0000176) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
Enumeration Date | 2005-08-31 |
Last Update Date | 2021-09-07 |