NPI | 1427326545 |
---|---|
Former Name | AMANDA NICOLE ROLIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 246Z00000X Specialist/Technologist, Other (Licence: NC LAT-2890) |
Additional Taxonomies | 133V00000X Dietitian, Registered |
2255A2300X Specialist/Technologist Athletic Trainer (Licence: VA 0126001719) | |
Enumeration Date | 2011-12-03 |
Last Update Date | 2023-06-28 |