| NPI | 1174284376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: 1183454) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-11-29 |