NPI | 1003160524 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC008) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 0000001308) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-11-06 |
Last Update Date | 2023-09-12 |