| NPI | 1053936088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5504) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0009263) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2025-06-30 |