| NPI | 1992406219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1572) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 15103) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-03-14 |
| Last Update Date | 2025-03-07 |