NPI | 1649498205 |
---|---|
Former Name | JAMIE MARIE HARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: LA J00236) |
Enumeration Date | 2007-04-20 |
Last Update Date | 2007-07-08 |