| NPI | 1801476916 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 4773)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 363A00000X Physician Assistant (Licence: TN 4773)  | |
| Enumeration Date | 2021-04-12 | 
| Last Update Date | 2024-10-11 |