| NPI | 1114499985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA060143) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004620) |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2022-04-26 |