NPI | 1639718810 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0001118) |
Enumeration Date | 2020-01-05 |
Last Update Date | 2024-09-16 |