| NPI | 1518636083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 10410) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AK 199750) |
| 363A00000X Physician Assistant (Licence: AZ 10410) | |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 10410) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2024-10-30 |