| NPI | 1154921047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9115833) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN Student) | |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2024-01-02 |