| NPI | 1770346595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC104) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004651A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-11-26 |