| NPI | 1104284983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1790) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60682912) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2025-07-25 |