NPI | 1417366089 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13671) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 10341008-4810) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-08-08 |
Last Update Date | 2023-10-16 |