| NPI | 1801362108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363AS0400X Physician Assistant Surgical (Licence: AZ PENDING) | |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2025-08-22 |