NPI | 1558448373 |
---|---|
Former Name | JENNIFIER R PRESTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ND 310-06) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 1899) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2007-07-08 |