| NPI | 1134723802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-11826) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 4042) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2022-05-25 |