| NPI | 1164008306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 261QP0905X Clinic/Center Public Health, State or Local |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2021-03-18 |