NPI | 1912533811 |
---|---|
Former Name | NICOLE JUSTINE DREGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 663) |
Enumeration Date | 2020-03-23 |
Last Update Date | 2020-03-23 |