NPI | 1376945972 |
---|---|
Former Name | AMY SUZANNE DWYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0000645) |
Enumeration Date | 2014-09-25 |
Last Update Date | 2014-09-25 |