| NPI | 1063099844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12795) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003441A) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2023-03-04 |