| NPI | 1083204994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010692) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11881) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2025-04-25 |