NPI | 1548752066 |
---|---|
Former Name | SHANNON WOODRUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36001839A) |
Enumeration Date | 2018-05-31 |
Last Update Date | 2018-05-31 |