| NPI | 1356883151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NV 0506505) | |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2025-10-10 |