| NPI | 1629558614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 1152) |
| Enumeration Date | 2018-08-19 |
| Last Update Date | 2026-03-27 |