| NPI | 1144845108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12562785-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: UT 12562785-1206) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2024-01-24 |