| NPI | 1407963549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126-000995) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2012-05-23 |