| NPI | 1245108935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110012036) |
| Enumeration Date | 2025-10-25 |
| Last Update Date | 2026-07-22 |