| NPI | 1275161358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL 9118332) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: SC 4461) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2024-09-04 |