| NPI | 1366066177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11047) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NC 0010-11047) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2024-02-15 |