| NPI | 1972919074 |
|---|---|
| Former Name | ANNA CAROL PORTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT002617) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY AT979) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2021-02-28 |