| NPI | 1124790142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2022001190) |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2022-05-31 |