| NPI | 1801225149 |
|---|---|
| Former Name | SHAUNA LEE HENRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0000389) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2013-11-07 |