NPI | 1669859195 |
---|---|
Former Name | CHRISTINE MARIE MAYOROS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601000773) |
Enumeration Date | 2015-05-05 |
Last Update Date | 2015-05-05 |