NPI | 1851337224 |
---|---|
Former Name | JERLYN DEE PADEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 24-00056) |
Enumeration Date | 2006-06-22 |
Last Update Date | 2008-11-18 |