| NPI | 1154100881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NE 2993) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 121904) |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2024-01-23 |