| NPI | 1518305879 |
|---|---|
| Former Name | LISA CHINN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0001128) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT004080) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2020-09-09 |