| NPI | 1386357440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-13448) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13448) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2023-10-06 |