| NPI | 1285142752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-103155) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7332) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2024-02-19 |