| NPI | 1861048787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11303) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3607) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2023-02-20 |