| NPI | 1619600988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: WI 7456-23) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363A00000X Physician Assistant (Licence: WI 7456-23) | |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2025-09-05 |