| NPI | 1790314102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C08417) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0008417) | |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2026-01-08 |