NPI | 1932639325 |
---|---|
Former Name | TIFFANI LYNN MEREDITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AR 753) |
Enumeration Date | 2017-06-18 |
Last Update Date | 2017-06-18 |