| NPI | 1275098667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WV 3080) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 225400000X Rehabilitation Practitioner | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-02-10 |
| Last Update Date | 2025-09-30 |