| NPI | 1356121974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: 1215983) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA065702) |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2024-08-28 |