NPI | 1396357190 |
---|---|
Former Name | KAYLA CZARNEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001635) |
Enumeration Date | 2020-08-21 |
Last Update Date | 2020-08-21 |