| NPI | 1003559832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-11992) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA063462) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2022-04-19 |