| NPI | 1760032775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007241) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 146L00000X Emergency Medical Technician, Paramedic | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2020-09-02 |