NPI | 1790014918 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT001711) |
Enumeration Date | 2009-12-17 |
Last Update Date | 2025-08-30 |