| NPI | 1245979095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 62675) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 4517) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2023-06-21 |