| NPI | 1861841223 |
|---|---|
| Former Name | MEGHAN ELIZABETH FORNOFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL2184) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2016-06-07 |