NPI | 1790209187 |
---|---|
Former Name | ANDREA ALLISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2017025985) |
Enumeration Date | 2017-07-27 |
Last Update Date | 2023-02-14 |