| NPI | 1538786678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010082) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085008004) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-07-05 |
| Last Update Date | 2024-07-23 |