| NPI | 1225718141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006621) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA064891) |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2024-03-21 |