| NPI | 1063138170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10566) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: OK 4865) | |
| 363A00000X Physician Assistant (Licence: KS 15-02718) | |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2025-03-05 |