| NPI | 1467228916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9119905) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 11165) |
| 363A00000X Physician Assistant (Licence: MI 5601012455) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2026-07-07 |