NPI | 1952076333 |
---|---|
Former Name | BRENDA LOU KNIFFEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2015023436) |
Enumeration Date | 2021-08-09 |
Last Update Date | 2021-08-09 |