| NPI | 1053033563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-1129) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: MO 2023009002) | |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2023-04-26 |