| NPI | 1477006278 |
|---|---|
| Former Name | CARLY RENAE GREGORY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH 004951) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-07-27 |