| NPI | 1114690781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 65607) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085008768) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2025-04-14 |