NPI | 1750880647 |
---|---|
Former Name | SAMANTHA MARIA KENDALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601001073) |
Enumeration Date | 2018-02-06 |
Last Update Date | 2018-02-06 |