| NPI | 1013572668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060687) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004851) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-06-20 |