| NPI | 1740900067 |
|---|---|
| Former Name | LORIANN MATHEWS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002376A) |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2022-08-29 |