| NPI | 1376195628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61163333) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006610) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2021-08-03 |