NPI | 1063138170 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10566) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 4865) |
363A00000X Physician Assistant (Licence: KS 15-02718) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-10-19 |
Last Update Date | 2024-11-14 |