| NPI | 1255924643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012389) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003368A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2024-06-03 |