| NPI | 1003553306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA063808) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AM0700X Physician Assistant, Medical (Licence: MD C0008546) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2023-12-12 |