| NPI | 1790574002 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: FL aa1078) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2025-05-02 | 
| Last Update Date | 2025-09-02 |