NPI | 1689340135 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC AT03117) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003386) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT8172) | |
Enumeration Date | 2021-08-16 |
Last Update Date | 2021-08-16 |