NPI | 1952813347 |
---|---|
Former Name | MARY KATHLEEN MCCAULEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002538A) |
Enumeration Date | 2017-10-25 |
Last Update Date | 2017-10-25 |