| NPI | 1881366847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 1076-PA) |
| 208D00000X General Practice (Licence: PR 24738) | |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2025-11-26 |