| NPI | 1184248437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MO 2023028228) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02496) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2023-08-24 |