| NPI | 1811680325 |
|---|---|
| Former Name | AMBER ROSE DEDOMING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-2519) |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2023-05-31 |