NPI | 1760443345 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.006687) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
363A00000X Physician Assistant (Licence: WA PA60499313) | |
Enumeration Date | 2006-03-31 |
Last Update Date | 2024-08-05 |