| NPI | 1013621796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14776) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA064290) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2024-12-17 |