NPI | 1891144028 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-1371) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
363A00000X Physician Assistant | |
Enumeration Date | 2016-06-08 |
Last Update Date | 2025-04-07 |