NPI | 1942617840 |
---|---|
Former Name | KATHERINE LEE HECKENBACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 67002433) |
Enumeration Date | 2014-07-13 |
Last Update Date | 2022-04-29 |