NPI | 1578244125 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2255A2300X Specialist/Technologist, Athletic Trainer | |
Enumeration Date | 2023-07-27 |
Last Update Date | 2024-08-07 |