| NPI | 1215527882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1383) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 107042) |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2022-11-18 |