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 |