| NPI | 1538824156 |
|---|---|
| Former Name | ALEXANDRA IAKIMENKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT008192) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: PA 0912212) |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2024-12-05 |