NPI | 1518276476 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36001732A) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: WA A1 60047440) |
Enumeration Date | 2010-09-27 |
Last Update Date | 2010-09-27 |