| NPI | 1609305523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 39493) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2024-05-02 |