| NPI | 1710372784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 97369331206) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 7538) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2018-03-17 |