| NPI | 1821484486 |
|---|---|
| Former Name | MELISSA M STALOWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ 0493) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-11-30 |