NPI | 1609516889 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14728) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ Pending) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-03-29 |
Last Update Date | 2023-11-30 |