NPI | 1578183505 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14929) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085008395) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-04-20 |
Last Update Date | 2025-01-28 |