| NPI | 1174102917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12801) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.1839) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2023-12-07 |