NPI | 1588026116 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 5098) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 24-00949) |
Enumeration Date | 2016-03-23 |
Last Update Date | 2024-09-30 |