| NPI | 1184288722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.008508) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113327) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2025-04-10 |