| NPI | 1285274829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005125) |
| Enumeration Date | 2020-01-12 |
| Last Update Date | 2022-09-21 |