| NPI | 1013253228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2024-03-07 |