| NPI | 1811527989 |
|---|---|
| Former Name | NICOLE AMBER THOMASON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: FL AL3489) |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-17 |