| NPI | 1699217430 |
|---|---|
| Former Name | MICHELLE KAREN HUBBARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: LA ATH.200403) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2016-11-10 |