| NPI | 1578214458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009876) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2023028270) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2023-08-10 |