NPI | 1437404548 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113017) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL2836) |
Enumeration Date | 2012-07-16 |
Last Update Date | 2024-11-21 |