| NPI | 1740879972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0007317) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 59196) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2022-07-13 |