NPI | 1457724452 |
---|---|
Former Name | CARRIE ANN HANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 6922421-4810) |
Enumeration Date | 2015-11-12 |
Last Update Date | 2015-11-12 |