| NPI | 1215534722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-12043) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12043) |
| 363AS0400X Physician Assistant, Surgical | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2023-06-01 |