| NPI | 1942074711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA222574) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA64972) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2024-12-23 |