| NPI | 1356883151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NV 0506505) |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2024-03-11 |