| NPI | 1487291829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 004789) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4789) |
| 363A00000X Physician Assistant (Licence: CO PA.0007035) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2021-11-16 |