NPI | 1649745258 |
---|---|
Former Name | RACHEL RENE SHELTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NE 1139) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 120211) |
Enumeration Date | 2018-10-10 |
Last Update Date | 2023-10-10 |