| NPI | 1508431933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2023-01-30 |