| NPI | 1295348811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3668) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12557) |
| 207Q00000X Family Medicine (Licence: SC 3668) | |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2024-04-18 |