| NPI | 1205426145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AR PA-960) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0984) |
| 363A00000X Physician Assistant (Licence: MN 14307) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2022-12-22 |