| NPI | 1902104698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9105907) |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2023-06-27 |