| NPI | 1043789225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3104) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC TL3104) |
| Enumeration Date | 2018-11-18 |
| Last Update Date | 2020-11-17 |