| NPI | 1578885018 |
|---|---|
| Former Name | KRISTEN MARIE DANIELS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.003149) |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2012-03-22 |