| NPI | 1447317383 |
|---|---|
| Former Name | AMANDA R BERGMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IL 096.002221) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2010-03-23 |