| NPI | 1518531755 |
|---|---|
| Former Name | AMY MARGUERITE HEINRICHS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.002797) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2021-05-13 |