| NPI | 1942921168 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2862) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 117739) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-09-06 | 
| Last Update Date | 2023-03-20 |