NPI | 1841677440 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009815) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-05-03 |
Last Update Date | 2020-01-30 |