| NPI | 1376767210 |
|---|---|
| Former Name | TINA LEAH NIEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: GA AT000887) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |