NPI | 1942667498 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007942) |
Additional Taxonomies | 363A00000X Physician Assistant |
390200000X Student in an Organized Health Care Education/Training Program | |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096004258) | |
Enumeration Date | 2016-01-27 |
Last Update Date | 2023-12-08 |