| NPI | 1477141513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001012677) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 390200000X) |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2022-10-14 |