| NPI | 1194252197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9187) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12435) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2022-09-29 |