| NPI | 1760236095 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2024-04-15 | 
| Last Update Date | 2024-04-15 |