| NPI | 1275289894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 4179) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 7149) |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2024-04-29 |