| NPI | 1154141117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MO 2024034282) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2024034282) |
| Enumeration Date | 2024-10-15 |
| Last Update Date | 2024-10-15 |