NPI | 1164985867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID 3271156) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 4845) |
363A00000X Physician Assistant (Licence: KY PA2816) | |
363AM0700X Physician Assistant, Medical (Licence: KY TC074) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-09 |
Last Update Date | 2025-07-21 |