| NPI | 1215564117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2420) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 2420) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2024-07-25 |