| NPI | 1649670647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC BOC308527) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2019-01-16 |