| NPI | 1891339040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-007893) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA200001277) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2023-03-07 |