| NPI | 1992192546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: IL 060564473) |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2023-05-02 |