| NPI | 1134776131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-LIC-127815) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006595) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2026-06-22 |