NPI | 1427229756 |
---|---|
Former Name | KATHRYN LYNN DASTYCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.002585) |
Enumeration Date | 2008-03-14 |
Last Update Date | 2021-04-22 |