| NPI | 1386137792 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA195775) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 363A00000X Physician Assistant | |
| Enumeration Date | 2018-06-11 | 
| Last Update Date | 2022-06-16 |