NPI | 1508353392 |
---|---|
Former Name | TARA ESKRIDGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: TX AT3676) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: TX 040602046) |
Enumeration Date | 2018-04-17 |
Last Update Date | 2018-04-17 |