| NPI | 1689371700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC380) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 7311) |
| 363A00000X Physician Assistant (Licence: CA 65994) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2026-01-08 |