NPI | 1518492503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA2803) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AL 1897) |
Enumeration Date | 2017-04-27 |
Last Update Date | 2023-04-04 |