| NPI | 1124501077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16995) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003826) |
| 146N00000X Emergency Medical Technician, Basic (Licence: GA E030790) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2023-10-20 |