| NPI | 1538850532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024022555) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA9117697) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-05-19 |
| Last Update Date | 2024-09-16 |