| NPI | 1659884336 |
|---|---|
| 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: MI 5601012852) |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2024-10-16 |