| NPI | 1508930637 |
|---|---|
| Former Name | BREANNA MARIE SALUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 732-039) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |