| NPI | 1558387712 |
|---|---|
| Former Name | JENNIFER M NIELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA 079902466) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2015-01-01 |