| NPI | 1700515038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 6471354) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA213536) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2025-07-28 |