| NPI | 1710241393 |
|---|---|
| Former Name | MEGAN MARIE PROBASCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 000989) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2025-09-16 |