| NPI | 1568922581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012352) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DE 2000033637) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-12-30 |