| NPI | 1972825107 |
|---|---|
| Former Name | JENNIFER NICOLE SUTYAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 1757) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2015-02-06 |