NPI | 1487299319 |
---|---|
Former Name | DEVON CLAIRE FEGLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DE J3-0000302) |
Enumeration Date | 2019-11-14 |
Last Update Date | 2020-04-20 |