NPI | 1972980365 |
---|---|
Former Name | COURTNEY FERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 2357-39) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 2911) |
Enumeration Date | 2015-05-05 |
Last Update Date | 2021-01-11 |