| NPI | 1215479019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1445) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA180184) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2023-10-31 |