NPI | 1104401389 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5159) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085008435) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-03-10 |
Last Update Date | 2023-04-05 |