| NPI | 1407374945 |
|---|---|
| Former Name | KATHLEEN ELIZABETH MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL2747) |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2022-07-21 |