| NPI | 1568571172 |
|---|---|
| Former Name | ELISABETH CORLISS MACRUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NH 1335) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-06-27 |