NPI | 1730533704 |
---|---|
Former Name | BRANDI LYNN CALDERWOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT-0001318) |
Enumeration Date | 2016-04-15 |
Last Update Date | 2016-04-15 |