| NPI | 1033720941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA 323628) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 323628) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2021-04-27 |