| NPI | 1184151839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007118RX) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH AT006463) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2022-01-12 |