| NPI | 1477099281 |
|---|---|
| Former Name | TYRA ROCHELLE CHARLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX 2381) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |