| NPI | 1669979753 |
|---|---|
| Former Name | OLIVIA RAE KOSNIK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 24-01334) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2024-12-27 |