| NPI | 1326310673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IL 096.002685) |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2022-08-03 |