| NPI | 1790065142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53646) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09826) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2025-01-27 |