| NPI | 1194189167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058569) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2023-10-19 |