| NPI | 1942965926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15474) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT8127) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2022-03-31 |