| NPI | 1588107155 |
|---|---|
| Former Name | NICOLE MARIE PFUTZENREUTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 2000023176) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2020-01-19 |