| NPI | 1972005452 |
|---|---|
| Former Name | SHAINA MARIE OCONNOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IL 096003023) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |