| NPI | 1477283414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023009782) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1202733) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2023-04-03 |