| NPI | 1184052508 |
|---|---|
| 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: CA PA54017) |
| 363A00000X Physician Assistant (Licence: MI 5601006710) | |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2025-04-22 |