NPI | 1528682002 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2738) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4423) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-06-01 |
Last Update Date | 2025-01-08 |