| NPI | 1154807865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA059932) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA004541) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2024-02-09 |