| NPI | 1780221291 |
|---|---|
| Former Name | CHRISTINA IPPOLITO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OR AT-10173689) |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-03 |