| NPI | 1619608635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12593) |
| Additional Taxonomies | 174400000X Specialist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2022-10-18 |