| NPI | 1972313930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
| 363A00000X Physician Assistant | |
| 363AS0400X Physician Assistant Surgical | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-01-11 |
| Last Update Date | 2025-02-03 |