| NPI | 1154814572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08165) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2021-11-10 |