| NPI | 1225292303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY WY445) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363A00000X Physician Assistant (Licence: MT 36138) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2015-11-05 |