NPI | 1568964369 |
---|---|
Former Name | TRACY ELIZABETH METRAILER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA BOC243906) |
Enumeration Date | 2018-03-07 |
Last Update Date | 2018-03-07 |