| NPI | 1275011256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.310472) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-10507) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2023-08-04 |