| NPI | 1306446166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062000) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA005390) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2023-04-24 |