| NPI | 1134534282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36001767A) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2019-07-10 |