| NPI | 1306301254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2323) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 095108) |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2022-02-01 |