| NPI | 1659966166 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8695) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-05 | 
| Last Update Date | 2025-09-24 |