| NPI | 1023581683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 4922) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363A00000X Physician Assistant (Licence: VA 0110006535) | |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2024-01-16 |