| NPI | 1598037251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR pa171331) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363AS0400X Physician Assistant, Surgical (Licence: MN 11080) | |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2015-04-08 |