NPI | 1992185375 |
---|---|
Former Name | HALEY ENGLEBERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 1745) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-06-01 |
Last Update Date | 2021-11-29 |