| NPI | 1558730093 |
|---|---|
| Former Name | CAITLYN MARIE VANWIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT002783) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0001523) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2025-07-24 |