| NPI | 1245977164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: MA PA9298) |
| Additional Taxonomies | 364SC2300X Clinical Nurse Specialist Chronic Care (Licence: MA PA9298) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2023-11-07 |