| NPI | 1194354928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11108) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4881) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2022-10-31 |