| NPI | 1740670223 |
|---|---|
| Former Name | LAURALEE VIRGINIA WILLIAMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002460A) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2019-08-12 |