NPI | 1689638066 |
---|---|
Former Name | PATRICIA A. SCHANK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 2666) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096-001286) |
Enumeration Date | 2006-04-13 |
Last Update Date | 2022-12-02 |