| NPI | 1396176681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 017015-1) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2025-04-25 |