| NPI | 1003439217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008540) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601011475) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2024-04-09 |