| NPI | 1720792898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 32698340) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 32698340) |
| Enumeration Date | 2023-01-12 |
| Last Update Date | 2023-01-23 |