| NPI | 1124304282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS019019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2019-00857) |
| 207Q00000X Family Medicine (Licence: PA OT017975) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT004794) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2020-06-30 |