| NPI | 1720687163 |
|---|---|
| Former Name | THERESA A GRATTAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2020-10-17 |
| Last Update Date | 2022-12-08 |