| NPI | 1972203784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA66084) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7431-23) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2025-06-23 |