NPI | 1720512510 |
---|---|
Former Name | REBEKAH MCDANIEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000020992) |
Enumeration Date | 2017-04-18 |
Last Update Date | 2020-09-16 |