| NPI | 1811406762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118239) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: MD C08029) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2023-12-05 |