NPI | 1437789427 |
---|---|
Former Name | JENIFER ANN SHOULTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601001138) |
Enumeration Date | 2020-01-19 |
Last Update Date | 2020-01-19 |