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 |