| NPI | 1790303055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NV PA2800) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA60223) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2023-12-04 |