NPI | 1659365468 |
---|---|
Former Name | JENNELL LYNN HOAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT003301) |
Enumeration Date | 2005-09-07 |
Last Update Date | 2007-07-08 |