| NPI | 1912483710 |
|---|---|
| Former Name | BRITTANY NICHOLE DIETER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: AZ 1316) |
| Enumeration Date | 2018-07-14 |
| Last Update Date | 2022-06-02 |