NPI | 1114332285 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-2464) |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2014-06-26 |
Last Update Date | 2025-03-03 |