| NPI | 1942750005 |
|---|---|
| Former Name | CAITLYN KUBIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00225000) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |