| NPI | 1023536927 |
|---|---|
| Former Name | TERILYN HUMPHREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2023-10-17 |