| NPI | 1962187237 |
|---|---|
| Former Name | KAYLA ANN CONRAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA 61319757) |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-15 |