| NPI | 1295394716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004926) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA060706) |
| Enumeration Date | 2019-06-08 |
| Last Update Date | 2023-08-15 |