| NPI | 1871058727 |
|---|---|
| Former Name | GINA THERESA MAGGIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 030002048) |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2019-02-05 |