| NPI | 1366894222 |
|---|---|
| Former Name | MALLORY ANNE SITZMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT4483) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2016-07-05 |