| NPI | 1316334410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11512) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: RI AT00379) |
| 363A00000X Physician Assistant | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2023-03-30 |