| NPI | 1720109143 |
|---|---|
| Former Name | NICOLE R HUMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 1662-39) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2024-08-07 |