| NPI | 1225500846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 1873) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL 1458) |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2022-12-22 |