| NPI | 1982186847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 13715) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003814) | |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2026-03-18 |