| NPI | 1326529041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4855) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6647) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2023-05-24 |