| NPI | 1528475662 |
|---|---|
| Former Name | ERIKA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003334) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RTO000181) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2018-12-19 |