NPI | 1891147898 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2021-0090) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NM 508665563) |
Enumeration Date | 2016-07-01 |
Last Update Date | 2024-05-08 |