| NPI | 1891579272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-130231) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2023-10-25 |