NPI | 1376594796 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51807) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 1757) |
Enumeration Date | 2006-05-12 |
Last Update Date | 2023-04-06 |