| NPI | 1386331064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA100937) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007950) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2024-09-18 |