| NPI | 1093299075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 333188) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006948) |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2022-08-26 |