| NPI | 1598389124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59307) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5295-23) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2022-01-18 |