| NPI | 1326626235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 112399) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5400-23) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2023-11-29 |