| NPI | 1235969908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 033628) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2026-07-15 |