| NPI | 1255141826 |
|---|---|
| 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: OR PA228848) |
| Enumeration Date | 2025-01-07 |
| Last Update Date | 2026-02-11 |