| NPI | 1497387500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11834) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007706) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2024-09-06 |