| NPI | 1851867626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD Co7263) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD C07263) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2023-06-22 |