| NPI | 1114578994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.1526) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006959) |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2023-05-18 |