| NPI | 1356863666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: 1145461) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: ID PA-1997) | |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2024-02-13 |