| NPI | 1184072498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2487) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV 2487) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2021-09-01 |