| NPI | 1295482032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 7060-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7060-23) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2022-08-25 |