NPI | 1952012866 |
---|---|
Former Name | MADISON MICHAEL PRESTO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RTO000245) |
Enumeration Date | 2022-12-12 |
Last Update Date | 2022-12-12 |