| NPI | 1194387555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA9566) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2019-0049) |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2023-09-19 |