| NPI | 1275312308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA064952) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA006688) |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2023-10-17 |