| NPI | 1174072987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059629) |
| 363A00000X Physician Assistant (Licence: CT 23.003674) | |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2024-06-24 |