| NPI | 1609254192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004868RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 180114) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2020-10-31 |