| NPI | 1356814040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12558) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2019004090) |
| 363A00000X Physician Assistant (Licence: MD C0008113) | |
| Enumeration Date | 2019-01-06 |
| Last Update Date | 2022-09-23 |