NPI | 1679826564 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KY AT750) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
Enumeration Date | 2012-10-17 |
Last Update Date | 2019-08-26 |