| NPI | 1992231955 |
|---|---|
| Former Name | CARRIE JUNE MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT4367) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |