NPI | 1538710629 |
---|---|
Former Name | KRISTEN ABBOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RTO000124) |
Enumeration Date | 2019-09-20 |
Last Update Date | 2019-09-20 |