| NPI | 1083264303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2550) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 106294) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2023-02-13 |