| NPI | 1578209391 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 61738)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-05-05 | 
| Last Update Date | 2025-07-18 |