NPI | 1538635396 |
---|---|
Former Name | AMELIA ALEXANDRA REEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 3246) |
Enumeration Date | 2018-10-19 |
Last Update Date | 2019-08-02 |