| NPI | 1154787893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA058070) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA OA003888) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2023-10-23 |