| NPI | 1093265498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003998) |
| 363A00000X Physician Assistant (Licence: PA MA058766) | |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2021-04-23 |