| NPI | 1306672811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024046032) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-12-20 |